22 August 2024: Due to technical disruption, we are experiencing some delays to publication. We are working to restore services and apologise for the inconvenience. For further updates please visit our website: https://www.cambridge.org/universitypress/about-us/news-and-blogs/cambridge-university-press-publishing-update-following-technical-disruption
We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.
This journal utilises an Online Peer Review Service (OPRS) for submissions. By clicking "Continue" you will be taken to our partner site
https://mc.manuscriptcentral.com/pdm.
Please be aware that your Cambridge account is not valid for this OPRS and registration is required. We strongly advise you to read all "Author instructions" in the "Journal information" area prior to submitting.
To save this undefined to your undefined account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you used this feature, you will be asked to authorise Cambridge Core to connect with your undefined account.
Find out more about saving content to .
To save this article to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below.
Find out more about saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
In the prehospital setting, the emergency care provider must anticipate that some patients will manifest with difficult airways. The use of video laryngoscopy to secure an airway in the prehospital setting has not been explored widely, but has the potential to be a useful tool. This article briefly reviews some of the major video laryngoscopes on the market and their usefulness in the prehospital setting. Studies and case reports indicate that the video laryngoscope is a promising device for emergency intubation, and it has been predicted that, in the future, video laryngoscopy will dominate the field of emergency airway management.
Direct laryngoscopy always should be retained as a primary skill; however, the video laryngoscope has the potential to be a good primary choice for the patient with potential cervical spine injuries or limited jaw or spine mobility, and in the difficult-to-access patient.The role of video laryngoscopes in securing an airway in head and neck trauma victims in the prehospital setting has yet to be determined, but offers interesting possibilities. Further clinical studies are necessary to evaluate its role in airway management by prehospital emergency medical services.
On 21 June 2005, a passenger train collided with a truck near Revadim, Israel.The collision resulted in a multiple-scene mass-casualty incident in an area characterized by difficult access and a relatively long distance from trauma centers. A major disaster response was initiated by civilian and military medical forces including the Israeli Air Force (IAF) Search and Rescue teams. The air-medical evacuation from the accident site to the trauma centers, the activities of the airborne medical teams, and the lessons learned from this event are described in this report.
Methods:
A retrospective analysis of data gathered from relevant elements that participated in management, treatment, and evacuation from the accident site was conducted.
Results:
The accident resulted in 289 injured passengers and seven of the injured were killed. Six helicopters (performing nine sorties) participated. Helicopters evacuated trauma victims and aided in transporting air-medical teams to the site of the collision.Overall, 35 trauma victims (10 urgent) were evacuated by air to trauma centers. The length of time between the first helicopter landing and completion of the air evacuation was 83 minutes. The airmedical evacuation operation was controlled by the commander of the IAF Search and Rescue. Different crew compositions were set in real time.
Conclusions:
Air-medical evacuation during this unique event enabled prompt transportation of casualties from the scene to trauma centers and provided reasonable distribution of patients between various centers in the region.This operation highlighted the necessity for flexibility in medical decision-making and the need for non-conventional solutions regarding crew compositions during management of an airborne evacuation in similar settings. Air-medical evacuation should be considered as a part of responses to mass-casualty incidents, especially when the site is remote or characterized by accessibility difficulties.
There is a common belief that an influenza pandemic not only is inevitable, but that it is imminent. It is further believed by some, and dramatized by a 2006 made-for-television-movie, that such a pandemic will herald an end to life as we know it. Are such claims hyperboles, or does a pandemic represent the most significant threat to public health in the new millennium? Any potential effects of a disease on a population are mediated not only through the pathophysiological mechanisms of the disease itself, but through the psychological and behavioral reactions that such a disease might engender. It is the purpose of this paper to explore the potential psychological and behavioral reactions that may accompany an influenza pandemic.
More than half of the world's disasters occur in the Asia-Pacific region. A simulation-based exercise to teach healthcare workers prehospital triage, tagging, and treatment methods was used to link disaster management theory to practice with a student-centered, hands-on educational activity. Various strategies for teaching disaster health education have been advocated, and best-practice disaster education models continue to be sought.
Methods:
A manikin-based, primary triage and treatment course was adapted for international healthcare providers in the Asia-Pacific region using symbolic representations of triage categories and physical findings. The pedagogical construct that was used was an interactive, formative assessment in which faculty members mediated learner information gathering and interpretation during four simulation scenarios. After establishing a multi-casualty disaster context, a wireless, audience response system anonymously collected learner responses to four clinical situations: (1) leg wound (hemorrhagic shock/immediate); (2) chest wound (tension pneumothorax/immediate); (3) head wound (traumatic brain injury/expectant); and (4) limb trauma (leg fracture/delayed).
Results:
There were 182 healthcare providers from eight Asia-Pacific countries (including the US) that participated in four simulation seminars. The simulation sessions were successfully tailored to groups of learners that varied in size and professional composition.Expectant and delayed triage categories posed the greatest challenge to learners. In one of two groups that were queried, learner self-confidence in applying principles of triage and treatment improved significantly. At the conclusion of the simulation sessions, learners strongly agreed that manikin-based simulation improved their understanding of triage, and should be used to teach principles of primary triage and treatment.
Conclusions:
Simulation training represents an opportunity to engage learners regardless of language and cultural barriers. Simulation-based training can be effective in introducing healthcare professionals to principles of primary triage and treatment in an effective and culturally sensitive manner.The characteristics of the course with respect to planned formative assessment and culturally competent scholarship were reviewed.
Hospital plans often vary when it comes to the specific functional roles that are included in emergency and incident management positions.Bioterrorism coordinators and emergency managers for 31 hospitals in a seven-county region outside of a major metropolitan area, with urban, suburban, and rural demographics were surveyed to determine which specific functional roles were considered “essential” to their hospital's emergency operations plans. Furthermore, they were asked to estimate the percentage of their “essential” staff trained to perform the functional roles delineated in the hospital's plan. Responses were entered into a database and descriptive statistical computations were performed. Only three categories of hospital personnel were reported to be “essential” by all hospitals to their emergency preparedness plans: emergency department physicians, nurse, and support staff. Training for overall “essential” staff ranged by hospital 73.6–83.3%. Some hospitals reported that these staff members have received no training in their anticipated role based on the hospital emergency response plan. Allied health professionals and emergency medical technicians/paramedics (that are employed by hospitals) had the least amount of training on their role in the hospital preparedness and response plan, 33.3% and 22.2% respectively.Without improved guidance on benchmarks for preparedness from regulators and professional organizations, hospitals will continue to lack the capacity to effectively respond to disasters and public health emergencies.
The medical system has an important role in response to a radiological emergency. Although the Radiation Emergency Medical Preparedness and Assistance Network (REMPAN) exists, every country must provide elements of preparedness of a national medical system for managing radiological emergencies.
Methods:
A research group consisting of experts reviewed the literature and related plans; International Atomic Energy Agency (IAEA) standards also were considered. Based on a three-level approach, preparedness elements of the national medical system were determined.
Results:
An emergency medical services (EMS) team for each district is to be trained. The competence of the team members, requisite equipment, procedures for rapidly preparing an ambulance, triage, and decontamination procedures were compiled. For each province, a prepared general hospital and its teams should develop: (1) radiological assessment capability; (2) triage; and (3) decontamination preparedness intervention. A radiation emergency receiving area, equipment list, personal protective equipment, and cooperation with specialized centers were considered. Each country must have a specialized hospital for medical management, training, and connection with REMPAN. All specialized departments, unique instruments, specific drugs, and'necessary procedures were defined. Also, tlie development of a mobile medical support team that could be accessed from the region.
Discussion:
Although radiological emergencies are rare, a national medical system must provide a comprehensive emergency management plan and be prepared for incidents.